High-intensity
progressive resistance strength training (HIPRST) improves lower limb strength
more than lesser training intensities in older adults, although it may not be
required to improve functional performance, say authors of a systematic review published this
month in Archives of Physical Medicine
and Rehabilitation. They note that training volume also is an important
variable, and HIPRST appears to be a safe mode of exercise in this population.

For
this systematic review, the authors searched online databases from their
inception to July 2012. Randomized controlled trials of HIPRST of the lower
limb compared with other intensities of PRST in older people (mean age ≥ 65
years) were identified. Two reviewers independently completed quality
assessment using the PEDro Scale and data extraction using a prepared
checklist.

The
authors included 21 trials. Study quality was fair to moderate (PEDro Scale
range 3 to 7). Studies had small sample sizes (18 to 84) and participants were
generally healthy. Meta-analyses revealed HIPRST improved lower limb strength
greater than moderate- and low-intensity PRST, SMD 0.79 and 0.83, respectively.
Studies where groups performed equivalent training volumes resulted in similar
improvements in leg strength, regardless of training intensity. Similar
improvements were found across intensities for functional performance and disability.
The effect of intensity of PRST on mood was inconsistent across studies.
Adverse events were poorly reported; however, no correlation was found between
training intensity and severity of adverse event.

The
authors call for further research into HIPRST's effects in older people with
chronic health conditions across the care continuum.